Hosted by Daniel Williams and Colleen Luckett, this episode of MGMA Weekend Review addresses issues in healthcare concerning AI compliance and clinician burnout. Drawing insights from the 2025 HIMSS Global Conference, the hosts discuss challenges and best practices for integrating AI within HIPAA constraints. The episode also highlights the importance of provider wellness, the ongoing struggle with prior authorization processes, lessons from disaster response, and strategies for mitigating clinician burnout.
00:00 Introduction and Hosts
00:30 AI and HIPAA Compliance Challenges (MGMA Article, MGMA Playbook)
04:46 Provider Wellness and Patient Satisfaction (Physicians Practice)
07:16 Prior Authorization Struggles (Fierce Healthcare)
11:17 Disaster Response Lessons from Maui (Becker's Hospital Review)
14:17 Clinician Burnout: Current Strategies and Statistics (MGMA Stat)
18:02 Conclusion and Farewell
Additional Resources:
- MGMA DataDive — Benchmark data to guide smarter decision-making
- MGMA Cybersecurity Playbook — Tools and strategies for keeping your practice safe
- Ask by Jeff Wetzler — This is the MGMA Book Club's April selection
- Join MGMA Communities — Collaborate with healthcare leaders and practice managers
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Daniel Williams (00:05):
Well, hi, everyone. Daniel Williams here,
senior editor at MGMA and hostof the MGMA Podcast Network. We
are back with another MGMA weekin review podcast along with
cohost Colleen Luckett, editorand writer at MGMA, and we're
gonna share some news with youon this April. So Colleen, what
(00:27):
is going on?
Colleen Luckett (00:28):
Yeah. Happy April, everyone. Well, if you've
ever felt like AI is movingfaster than your compliance
officer can say businessassociate agreement, you are not
alone. Indeed, one of thebiggest questions healthcare
leaders are facing right now ishow do you harness the promise
of AI without triggering a HIPAAheadache? To help answer this
(00:49):
question, let's turn to insightsfrom the recent twenty twenty
five HIMSS Global Conference,where MGMA's own Chris Harrop
and my manager was on the groundreporting.
Chris sat in on a session led byAdam Green, a former HIPAA
regulator at HHS and now apartner at Davis Wright
Tremaine. The session jumped inwith both feet addressing one of
(01:11):
the thorniest issues in healthtech right now, how to develop
and deploy AI tools whilestaying compliant with privacy
laws written long before AI wason the scene. Green explained
that while HIPAA may betechnology neutral, it was
enacted in 1996, meaning itwasn't exactly built with
machine learning or predictivealgorithms in mind. Yet HIPAA
(01:32):
still governs how, when, and whyprotected health information, or
PHI, can be used. One of thebiggest sticking points, the
minimum necessary rule.
In other words, when using orsharing PHI, you have to limit
it to what's truly necessary forthe task at hand. And that's in
direct tension with AI, whichtypically thrives on as much
(01:53):
data as it can get. Another mythGreen debunked is the idea that
simply removing names or directidentifiers makes data HIPAA
compliant. That's not the case.HIPAA requires either an expert
statistical determination thatthe risk of re identification is
very small, or the removal of 18specific identifiers under the
(02:14):
safe harbor method.
And even then, some states, likeCalifornia, add further
restrictions on the use of saleor de identified health data.
Green emphasized that justbecause data is de identified
under HIPAA doesn't mean you'rein the clear, though. AI systems
often use unstructured data,like imaging, doctor's notes,
audio that can be incrediblyhard to fully de identify. When
(02:38):
data sets are combined fromdifferent sources, the risk of
re identifying individualsincreases significantly. One of
the most important warnings fromthe session came around HIPAA's
prohibition on the sale of PHI.
If a health system shares PHIwith a tech company, in exchange
for intellectual property or AItools, that can be interpreted
as a prohibited transaction,even if no money changes hands.
(03:02):
That's a key compliance risk forpractices partnering with AI
vendors. This session also duginto the fine line between
healthcare operations andresearch. Green explained that
helping your own patients withAI assisted tools usually falls
under operations, while effortsto generalize or commercialize
those tools may trigger HIPAA'sresearch requirements, like IRB
(03:24):
approvals or data useagreements. It's a gray area
with real implications.
And finally, Green remindedattendees that compliance isn't
just about checking boxes.Ethical considerations matter.
He pointed to Google's ProjectNightingale as a case where a
technically compliantpartnership still resulted in
massive public backlash. Hisadvice, appoint someone on your
(03:46):
team to play the role of ethicalwatchdog. Someone who asks the
question, would we becomfortable seeing this on the
front page of the newspaper?
For medical group leadersexploring AI, this is your
reminder to go beyond the tech,check your policies, revisit
your agreements, and thinkcarefully about how your data is
being used. And maybe updatethat dusty old HIPAA training
(04:06):
while you're at it. Thanks againto Chris Harrott for bringing
back this critical insight fromHIMSS twenty twenty five. MGMA
members can check out Chris'sfull session recap on the MGMA
website under practice resourcesand then articles. And hey, MGMA
is here to help with yourcybersecurity needs.
Head to MGMA.com and check outour new MGMA cybersecurity and
(04:29):
medical practices playbook. It'sa handy member exclusive
resource that provides all kindsof practical advice about
understanding HIPAA complianceand frameworks for protecting
secure data against thosethreats or accidental exposure.
Alright, Danielle, over to you.
Daniel Williams (04:46):
Yeah. Our next article really stuck with me.
It's called The Critical LinkBetween Provider Wellness and
Its Impact on PatientSatisfaction. It was written by
Randy Baldiga and published onApril 1 over at Physicians
Practice. It is not an AprilFools' joke.
(05:06):
The title really does say itall. The real impact is in how
clearly the author connects thedots between clinician burnout
and the overall patientexperience. The author cites
some pretty eye opening data,including a 2023 AMA survey
showing that sixty three percentof physicians reported at least
(05:28):
one symptom of burnout. Thatnumber has jumped significantly
from just a few years ago, andthe ripple effect is real. When
providers are stressed,exhausted, or emotionally
drained, it shows up in patientcare.
Communication suffers, empathytakes a hit, and trust, which is
(05:48):
so foundational in health care,starts to erode. What I
appreciated about this articleis that Boldiga doesn't just
stop at describing the problem.He points towards real
solutions. One of the biggestshifts he advocates for is
moving away from this idea thatindividual resilience is the
answer. Instead, he calls onorganizations to create
(06:12):
environments that activelysupport wellness through things
like flexible scheduling, teambased care, and smarter EHR
workflows.
The bottom line, if you'reseeing dips in your patient
satisfaction scores, you mightwant to look upstream. Provider
wellness isn't just a wellnessissue, it's a performance and
(06:34):
quality issue. As Boldiga putsit, the patient experience
begins with the providerexperience. And that's a fine
line I think a lot of readersneed to hear right now. This
kind of research should be frontand center in leadership
meetings.
We often get caught up in thenumbers, RVUs, throughput,
satisfaction scores, but it'seasy to forget that behind all
(06:57):
of those metrics are humanbeings showing up to care for
others. And if we want toimprove those numbers in a
sustainable way, we have toinvest in the people behind
them. Provider wellness isn'tjust a moral imperative. It's a
strategic one. Colleen, I'llturn it over to you.
Colleen Luckett (07:15):
Alright. Well, if prior authorization were a
person, it'd be the coworker whomakes you fill out three forms,
get a signature from your pastself, and wait two weeks just to
use the copier. We all know theprocess is frustrating, but for
some patients, it's not justannoying. It's life altering. So
we're looking next at a furioushealthcare story from April 2,
(07:39):
originally published by KFFHealth News called, They Won't
Help Me.
Sickest Patients Face InsuranceDenials Despite Policy Fixes. It
opens with the story of a 30year old woman living with small
fiber neuropathy, a conditionthat causes excruciating,
burning pain in her limbs. Herspecialist recommended IVIG
(08:01):
therapy, a plasma basedtreatment that could
dramatically improve her qualityof life. But her insurer,
Anthem, has repeatedly deniedthe request, citing insufficient
evidence of effectiveness forher condition, even though
multiple doctors support it. Shepays over $600 a month in
premiums and still can't accessthe treatment she needs.
(08:22):
Her only hope now lies in apending appeal to the Virginia
State Corporation Commission.Her case isn't unique. According
to patient advocates and healtheconomists, prior authorization,
originally designed to reducewaste and avoid unnecessary
care, has become a majorobstacle for some of the sickest
patients. The system is opaque,inconsistently applied, and
(08:45):
often delays or blocks care forthose who need it most. Even
when insurers claim to beimproving the process,
healthcare leaders remainskeptical.
Judson Ivey, CEO of EnsembleHealth Partners, said many so
called reforms look more like PRmoves than meaningful fixes,
leaving high cost services likeimaging and infusion therapy
(09:07):
still stuck in limbo. Oneexample, a resident physician
had to fight his own father'sinsurer to approve a PET scan
for staging lymphoma. Theapproval finally came weeks late
after multiple delays andcancellations that added stress
during an already terrifyingtime. There's growing public
outrage too. After the killingof UnitedHealthcare CEO Brian
(09:30):
Thompson last December, socialmedia exploded with stories of
treatment denials and prior authnightmares.
A somewhat understandable poll,depending on whom you speak to,
found forty one percent of youngadults considered the killer's
actions at least somewhatunderstandable. While no one
really condones this violence,this reflects the level of
(09:50):
unified anger among patients,doctors, and advocates who feel
trapped in a system built morefor profit than care. Both the
Trump and Biden administrationsattempted reforms, and
bipartisan efforts continue inCongress and state legislatures.
Some states have passed goldcard laws to ease the burden for
providers with strong approvaltrack records. But for many
(10:12):
patients, those changes haven'tcome fast enough or reached the
most critical care decisions.
And the fundamental issueremains: can a system designed
to control costs ever trulyprioritize the sickest patients?
As one advocate put it, tryingto reform prior authorizations
sometimes feels like playingwhack a mole. Insurance
companies always seem to findanother way to say no. At the
(10:35):
end of the day, no patientshould have to plead with a drug
company for charity while payinghundreds of dollars a month for
coverage. The system may not beeasy to change, but the stories
that are being shared louder andmore publicly than ever are
pushing us closer, hopefully, toa reckoning.
We will, as usual, drop thatfull article into the show
(10:55):
notes. Check out that linkthere. And if your practice is
seeing the impact of priorauthorization delays on care
delivery, we'd love to hear fromyou over at MGMA Connection
Magazine for an article. You canreach us there at
connection@mgma.com or emailDaniel or me if you wanna join
us on the podcast. Okay, Daniel.
Back to you.
Daniel Williams (11:15):
Alright. Thank you so much, Colleen. This next
one, a little bit personal. I'dlived in the LA area for almost
a decade and was up in thePasadena area in there, and so
nearby were the fires. So when Icame across this next article in
Becker's Hospital Review, reallyconnected with it.
(11:35):
So it was written by KellyGooch, published March 29, and
it's called responding todisaster, lessons from Maui
wildfires can help LA recover.And it really draws some
powerful parallels between thedevastating wildfires that swept
through Maui last year and thewildfires that have since
(11:57):
impacted the Los Angeles area.So what stands out here is the
emphasis on learning from pastdisasters, not just in theory,
but in how hospitals and healthcare leaders actually put those
lessons into practice. Goochhighlights examples from Hawaii
Pacific Health and KaiserPermanente, Hawaii, where
(12:18):
leadership focused on clearcommunication, staff support,
and agile problem solving tokeep care delivery moving under
incredibly challengingconditions. One of the biggest
takeaways, relationships matter.
Leaders who had already builtstrong internal teams and
external partnerships before thecrisis were able to respond more
(12:41):
quickly and effectively. It's areminder that trust and
coordination don't just happenovernight. You build them in the
quiet times so they're therewhen it counts. There's also a
strong human element in thepiece. It's not just about
emergency protocols andlogistics.
It's about how leadership showsup, being visible, listening,
(13:04):
supporting your team emotionallywhile helping them navigate the
chaos. Gooch makes the pointthat leadership presence can
carry people through momentswhen there are no perfect
answers. And when it comes topreparation, it's clear that
waiting until the fire is onyour doorstep is too late.
Having a plan, training yourteam, stress testing your
(13:28):
systems. These aren't just boxesto check.
They're what make the differencebetween reacting and responding.
The article suggests LA's HealthCare Leaders have a real
opportunity to learn from Maui'sexperience and apply it to their
own long term recovery andresilience planning. Again, this
this article really touched me.It is called, again, Responding
(13:51):
to Disaster, Lessons from MauiWildfires Can Help LA recover by
Kelly Gooch. It was published inBecker's Hospital Review.
It is well worth a look ifyou're thinking about disaster
preparedness and the roleleadership plays in the thick of
it. Colleen, what's next?
Colleen Luckett (14:10):
Yeah. I have a feeling those are going to come
fast and furious. Yeah. Comingyears, unfortunately. Thanks for
that.
So, everyone, Daniel talkedabout it earlier. And if you're
in health care, it may make youreyes glaze over at this point.
It's been said, studied,surveyed, and strategized to
death. What is it? Clinicianburnout.
(14:30):
Yeah. We get it. But here's thething. It's still happening. And
as long as clinicians arequietly, or not so quietly,
slipping out the side door ofthe profession, it's a topic we
can't afford to ignore.
So, in our latest MGMA statpoll, we wanted to know what, if
anything, medical grouppractices are doing to address
clinician burnout right now. Soon April 1, we asked, Has your
(14:55):
organization added or updatedany strategies for addressing
clinician burnout in the pastyear? Here's what we heard from
two ninety five healthcareleaders: 20 four percent of you
said yes, sixty six percent saidno, and 11% of you just weren't
quite sure. So about one in fourgroups are taking action, but
the majority haven't made recentchanges, which is a little
(15:17):
surprising considering theongoing risks. A previous poll
showed 27% of medical groups hadalready seen a physician retire
early or leave due to burnout.
The good news? For those whohave made updates, they're
getting creative. According toour full article, addressing
clinician burnout with a focuson their calling to medicine,
(15:38):
the stop the top strategiesinclude AI tools to reduce
documentation and billingworkloads, scheduling fixes like
four day work weeks, fewerweekend shifts, and real time
off. Mental health and wellnessofferings, everything from
therapy and coaching to the Calmapp subscriptions and massage
chairs. Training and engagement,such as therapist led workshops,
(16:02):
leadership groups, andinterview, state interviews.
Operational tweaks like hiringadditional support staff and
making lean processimprovements. And here's the
broader context. With the AAMCforecasting a shortage of up to
86,000 physicians by 02/1936,Keeping today's clinicians
(16:22):
connected to their work andwanting to stay isn't just a
culture issue. It's a workforceemergency. The article also
explores new research fromJackson Physician Search and
LocumTenens.com, which showsthat while 90% of physicians and
APPs entered the field with astrong sense of calling, over
half say that sense of purposehas faded.
(16:43):
That loss is being driven by,you guessed it, admin overload,
regulatory fatigue, and lack ofautonomy. Still, 81% of
clinicians say being a provideris central to who they are, and
77% say the positives of the jobstill outweigh the negatives.
Clinicians with a strong senseof purpose report lower burnout
and greater satisfaction. Sowhat can healthcare leaders do?
(17:07):
The report offers two keytakeaways.
Number one, reduce the adminburden so clinicians can spend
more time connecting withpatients. Two, protect work life
balance so they can rechargewith family, friends, and
purpose driven tasks. And onemore idea, mentorship across
generations. Baby boomers tendto express the highest joy and
(17:28):
sense of calling in their roles.Sharing that perspective with
younger clinicians could be partof the solution.
So yes, the word burnout may beoverused, but it still hits
hard, and it's not going awayuntil more organizations rethink
what it takes to keep theirclinicians engaged, not just
employed. You can read the fullarticle at MGMA.com. And as
(17:49):
always, if you want to helpshape future resources, sign up
for MGMA STAT by texting stat, st a t, to 33550. And that does
it for me today, Daniel.
Daniel Williams (18:02):
And that's gonna do it for us this week,
everyone. Thank you so much forlistening to the MGMA weekend
review podcast. We're stillgetting a little bit of snow
here in Colorado, so hopefully,y'all are getting some sunshine.
So until then, thank you all forbeing MGMA podcast listeners.
Colleen Luckett (18:19):
Thanks, everyone. See you next week.
Well, hi, everyone. Daniel Williams here,
senior editor at MGMA and hostof the MGMA Podcast Network. We
are back with another MGMA weekin review podcast along with
cohost Colleen Luckett, editorand writer at MGMA, and we're
gonna share some news with youon this April. So Colleen, what
(00:27):
is going on?
Colleen Luckett (00:28):
Yeah. Happy April, everyone. Well, if you've
ever felt like AI is movingfaster than your compliance
officer can say businessassociate agreement, you are not
alone. Indeed, one of thebiggest questions healthcare
leaders are facing right now ishow do you harness the promise
of AI without triggering a HIPAAheadache? To help answer this
(00:49):
question, let's turn to insightsfrom the recent twenty twenty
five HIMSS Global Conference,where MGMA's own Chris Harrop
and my manager was on the groundreporting.
Chris sat in on a session led byAdam Green, a former HIPAA
regulator at HHS and now apartner at Davis Wright
Tremaine. The session jumped inwith both feet addressing one of
(01:11):
the thorniest issues in healthtech right now, how to develop
and deploy AI tools whilestaying compliant with privacy
laws written long before AI wason the scene. Green explained
that while HIPAA may betechnology neutral, it was
enacted in 1996, meaning itwasn't exactly built with
machine learning or predictivealgorithms in mind. Yet HIPAA
(01:32):
still governs how, when, and whyprotected health information, or
PHI, can be used. One of thebiggest sticking points, the
minimum necessary rule.
In other words, when using orsharing PHI, you have to limit
it to what's truly necessary forthe task at hand. And that's in
direct tension with AI, whichtypically thrives on as much
(01:53):
data as it can get. Another mythGreen debunked is the idea that
simply removing names or directidentifiers makes data HIPAA
compliant. That's not the case.HIPAA requires either an expert
statistical determination thatthe risk of re identification is
very small, or the removal of 18specific identifiers under the
(02:14):
safe harbor method.
And even then, some states, likeCalifornia, add further
restrictions on the use of saleor de identified health data.
Green emphasized that justbecause data is de identified
under HIPAA doesn't mean you'rein the clear, though. AI systems
often use unstructured data,like imaging, doctor's notes,
audio that can be incrediblyhard to fully de identify. When
(02:38):
data sets are combined fromdifferent sources, the risk of
re identifying individualsincreases significantly. One of
the most important warnings fromthe session came around HIPAA's
prohibition on the sale of PHI.
If a health system shares PHIwith a tech company, in exchange
for intellectual property or AItools, that can be interpreted
as a prohibited transaction,even if no money changes hands.
(03:02):
That's a key compliance risk forpractices partnering with AI
vendors. This session also duginto the fine line between
healthcare operations andresearch. Green explained that
helping your own patients withAI assisted tools usually falls
under operations, while effortsto generalize or commercialize
those tools may trigger HIPAA'sresearch requirements, like IRB
(03:24):
approvals or data useagreements. It's a gray area
with real implications.
And finally, Green remindedattendees that compliance isn't
just about checking boxes.Ethical considerations matter.
He pointed to Google's ProjectNightingale as a case where a
technically compliantpartnership still resulted in
massive public backlash. Hisadvice, appoint someone on your
(03:46):
team to play the role of ethicalwatchdog. Someone who asks the
question, would we becomfortable seeing this on the
front page of the newspaper?
For medical group leadersexploring AI, this is your
reminder to go beyond the tech,check your policies, revisit
your agreements, and thinkcarefully about how your data is
being used. And maybe updatethat dusty old HIPAA training
(04:06):
while you're at it. Thanks againto Chris Harrott for bringing
back this critical insight fromHIMSS twenty twenty five. MGMA
members can check out Chris'sfull session recap on the MGMA
website under practice resourcesand then articles. And hey, MGMA
is here to help with yourcybersecurity needs.
Head to MGMA.com and check outour new MGMA cybersecurity and
(04:29):
medical practices playbook. It'sa handy member exclusive
resource that provides all kindsof practical advice about
understanding HIPAA complianceand frameworks for protecting
secure data against thosethreats or accidental exposure.
Alright, Danielle, over to you.
Daniel Williams (04:46):
Yeah. Our next article really stuck with me.
It's called The Critical LinkBetween Provider Wellness and
Its Impact on PatientSatisfaction. It was written by
Randy Baldiga and published onApril 1 over at Physicians
Practice. It is not an AprilFools' joke.
(05:06):
The title really does say itall. The real impact is in how
clearly the author connects thedots between clinician burnout
and the overall patientexperience. The author cites
some pretty eye opening data,including a 2023 AMA survey
showing that sixty three percentof physicians reported at least
(05:28):
one symptom of burnout. Thatnumber has jumped significantly
from just a few years ago, andthe ripple effect is real. When
providers are stressed,exhausted, or emotionally
drained, it shows up in patientcare.
Communication suffers, empathytakes a hit, and trust, which is
(05:48):
so foundational in health care,starts to erode. What I
appreciated about this articleis that Boldiga doesn't just
stop at describing the problem.He points towards real
solutions. One of the biggestshifts he advocates for is
moving away from this idea thatindividual resilience is the
answer. Instead, he calls onorganizations to create
(06:12):
environments that activelysupport wellness through things
like flexible scheduling, teambased care, and smarter EHR
workflows.
The bottom line, if you'reseeing dips in your patient
satisfaction scores, you mightwant to look upstream. Provider
wellness isn't just a wellnessissue, it's a performance and
(06:34):
quality issue. As Boldiga putsit, the patient experience
begins with the providerexperience. And that's a fine
line I think a lot of readersneed to hear right now. This
kind of research should be frontand center in leadership
meetings.
We often get caught up in thenumbers, RVUs, throughput,
satisfaction scores, but it'seasy to forget that behind all
(06:57):
of those metrics are humanbeings showing up to care for
others. And if we want toimprove those numbers in a
sustainable way, we have toinvest in the people behind
them. Provider wellness isn'tjust a moral imperative. It's a
strategic one. Colleen, I'llturn it over to you.
Colleen Luckett (07:15):
Alright. Well, if prior authorization were a
person, it'd be the coworker whomakes you fill out three forms,
get a signature from your pastself, and wait two weeks just to
use the copier. We all know theprocess is frustrating, but for
some patients, it's not justannoying. It's life altering. So
we're looking next at a furioushealthcare story from April 2,
(07:39):
originally published by KFFHealth News called, They Won't
Help Me.
Sickest Patients Face InsuranceDenials Despite Policy Fixes. It
opens with the story of a 30year old woman living with small
fiber neuropathy, a conditionthat causes excruciating,
burning pain in her limbs. Herspecialist recommended IVIG
(08:01):
therapy, a plasma basedtreatment that could
dramatically improve her qualityof life. But her insurer,
Anthem, has repeatedly deniedthe request, citing insufficient
evidence of effectiveness forher condition, even though
multiple doctors support it. Shepays over $600 a month in
premiums and still can't accessthe treatment she needs.
(08:22):
Her only hope now lies in apending appeal to the Virginia
State Corporation Commission.Her case isn't unique. According
to patient advocates and healtheconomists, prior authorization,
originally designed to reducewaste and avoid unnecessary
care, has become a majorobstacle for some of the sickest
patients. The system is opaque,inconsistently applied, and
(08:45):
often delays or blocks care forthose who need it most. Even
when insurers claim to beimproving the process,
healthcare leaders remainskeptical.
Judson Ivey, CEO of EnsembleHealth Partners, said many so
called reforms look more like PRmoves than meaningful fixes,
leaving high cost services likeimaging and infusion therapy
(09:07):
still stuck in limbo. Oneexample, a resident physician
had to fight his own father'sinsurer to approve a PET scan
for staging lymphoma. Theapproval finally came weeks late
after multiple delays andcancellations that added stress
during an already terrifyingtime. There's growing public
outrage too. After the killingof UnitedHealthcare CEO Brian
(09:30):
Thompson last December, socialmedia exploded with stories of
treatment denials and prior authnightmares.
A somewhat understandable poll,depending on whom you speak to,
found forty one percent of youngadults considered the killer's
actions at least somewhatunderstandable. While no one
really condones this violence,this reflects the level of
(09:50):
unified anger among patients,doctors, and advocates who feel
trapped in a system built morefor profit than care. Both the
Trump and Biden administrationsattempted reforms, and
bipartisan efforts continue inCongress and state legislatures.
Some states have passed goldcard laws to ease the burden for
providers with strong approvaltrack records. But for many
(10:12):
patients, those changes haven'tcome fast enough or reached the
most critical care decisions.
And the fundamental issueremains: can a system designed
to control costs ever trulyprioritize the sickest patients?
As one advocate put it, tryingto reform prior authorizations
sometimes feels like playingwhack a mole. Insurance
companies always seem to findanother way to say no. At the
(10:35):
end of the day, no patientshould have to plead with a drug
company for charity while payinghundreds of dollars a month for
coverage. The system may not beeasy to change, but the stories
that are being shared louder andmore publicly than ever are
pushing us closer, hopefully, toa reckoning.
We will, as usual, drop thatfull article into the show
(10:55):
notes. Check out that linkthere. And if your practice is
seeing the impact of priorauthorization delays on care
delivery, we'd love to hear fromyou over at MGMA Connection
Magazine for an article. You canreach us there at
connection@mgma.com or emailDaniel or me if you wanna join
us on the podcast. Okay, Daniel.
Back to you.
Daniel Williams (11:15):
Alright. Thank you so much, Colleen. This next
one, a little bit personal. I'dlived in the LA area for almost
a decade and was up in thePasadena area in there, and so
nearby were the fires. So when Icame across this next article in
Becker's Hospital Review, reallyconnected with it.
(11:35):
So it was written by KellyGooch, published March 29, and
it's called responding todisaster, lessons from Maui
wildfires can help LA recover.And it really draws some
powerful parallels between thedevastating wildfires that swept
through Maui last year and thewildfires that have since
(11:57):
impacted the Los Angeles area.So what stands out here is the
emphasis on learning from pastdisasters, not just in theory,
but in how hospitals and healthcare leaders actually put those
lessons into practice. Goochhighlights examples from Hawaii
Pacific Health and KaiserPermanente, Hawaii, where
(12:18):
leadership focused on clearcommunication, staff support,
and agile problem solving tokeep care delivery moving under
incredibly challengingconditions. One of the biggest
takeaways, relationships matter.
Leaders who had already builtstrong internal teams and
external partnerships before thecrisis were able to respond more
(12:41):
quickly and effectively. It's areminder that trust and
coordination don't just happenovernight. You build them in the
quiet times so they're therewhen it counts. There's also a
strong human element in thepiece. It's not just about
emergency protocols andlogistics.
It's about how leadership showsup, being visible, listening,
(13:04):
supporting your team emotionallywhile helping them navigate the
chaos. Gooch makes the pointthat leadership presence can
carry people through momentswhen there are no perfect
answers. And when it comes topreparation, it's clear that
waiting until the fire is onyour doorstep is too late.
Having a plan, training yourteam, stress testing your
(13:28):
systems. These aren't just boxesto check.
They're what make the differencebetween reacting and responding.
The article suggests LA's HealthCare Leaders have a real
opportunity to learn from Maui'sexperience and apply it to their
own long term recovery andresilience planning. Again, this
this article really touched me.It is called, again, Responding
(13:51):
to Disaster, Lessons from MauiWildfires Can Help LA recover by
Kelly Gooch. It was published inBecker's Hospital Review.
It is well worth a look ifyou're thinking about disaster
preparedness and the roleleadership plays in the thick of
it. Colleen, what's next?
Colleen Luckett (14:10):
Yeah. I have a feeling those are going to come
fast and furious. Yeah. Comingyears, unfortunately. Thanks for
that.
So, everyone, Daniel talkedabout it earlier. And if you're
in health care, it may make youreyes glaze over at this point.
It's been said, studied,surveyed, and strategized to
death. What is it? Clinicianburnout.
(14:30):
Yeah. We get it. But here's thething. It's still happening. And
as long as clinicians arequietly, or not so quietly,
slipping out the side door ofthe profession, it's a topic we
can't afford to ignore.
So, in our latest MGMA statpoll, we wanted to know what, if
anything, medical grouppractices are doing to address
clinician burnout right now. Soon April 1, we asked, Has your
(14:55):
organization added or updatedany strategies for addressing
clinician burnout in the pastyear? Here's what we heard from
two ninety five healthcareleaders: 20 four percent of you
said yes, sixty six percent saidno, and 11% of you just weren't
quite sure. So about one in fourgroups are taking action, but
the majority haven't made recentchanges, which is a little
(15:17):
surprising considering theongoing risks. A previous poll
showed 27% of medical groups hadalready seen a physician retire
early or leave due to burnout.
The good news? For those whohave made updates, they're
getting creative. According toour full article, addressing
clinician burnout with a focuson their calling to medicine,
(15:38):
the stop the top strategiesinclude AI tools to reduce
documentation and billingworkloads, scheduling fixes like
four day work weeks, fewerweekend shifts, and real time
off. Mental health and wellnessofferings, everything from
therapy and coaching to the Calmapp subscriptions and massage
chairs. Training and engagement,such as therapist led workshops,
(16:02):
leadership groups, andinterview, state interviews.
Operational tweaks like hiringadditional support staff and
making lean processimprovements. And here's the
broader context. With the AAMCforecasting a shortage of up to
86,000 physicians by 02/1936,Keeping today's clinicians
(16:22):
connected to their work andwanting to stay isn't just a
culture issue. It's a workforceemergency. The article also
explores new research fromJackson Physician Search and
LocumTenens.com, which showsthat while 90% of physicians and
APPs entered the field with astrong sense of calling, over
half say that sense of purposehas faded.
(16:43):
That loss is being driven by,you guessed it, admin overload,
regulatory fatigue, and lack ofautonomy. Still, 81% of
clinicians say being a provideris central to who they are, and
77% say the positives of the jobstill outweigh the negatives.
Clinicians with a strong senseof purpose report lower burnout
and greater satisfaction. Sowhat can healthcare leaders do?
(17:07):
The report offers two keytakeaways.
Number one, reduce the adminburden so clinicians can spend
more time connecting withpatients. Two, protect work life
balance so they can rechargewith family, friends, and
purpose driven tasks. And onemore idea, mentorship across
generations. Baby boomers tendto express the highest joy and
(17:28):
sense of calling in their roles.Sharing that perspective with
younger clinicians could be partof the solution.
So yes, the word burnout may beoverused, but it still hits
hard, and it's not going awayuntil more organizations rethink
what it takes to keep theirclinicians engaged, not just
employed. You can read the fullarticle at MGMA.com. And as
(17:49):
always, if you want to helpshape future resources, sign up
for MGMA STAT by texting stat, st a t, to 33550. And that does
it for me today, Daniel.
Daniel Williams (18:02):
And that's gonna do it for us this week,
everyone. Thank you so much forlistening to the MGMA weekend
review podcast. We're stillgetting a little bit of snow
here in Colorado, so hopefully,y'all are getting some sunshine.
So until then, thank you all forbeing MGMA podcast listeners.
Colleen Luckett (18:19):
Thanks, everyone. See you next week.
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